MEDICARE: CUMBERLAND COUNTY HOSPITAL SYSTEM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1235687385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUMBERLAND COUNTY HOSPITAL SYSTEM INC

Provider Business Mailing Address
First Line	:	PO BOX 40908
Second Line	:	ATTN: MANAGED CARE PLANNING
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28309-0908
Country	:	US
Telephone Number	:	910-615-6949
Fax Number	:

Provider Business Practice Location Address
First Line	:	588 BAILEY RD STE K
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-2470
Country	:	US
Telephone Number	:	910-739-8899
Fax Number	:	910-739-7174

Authorized Official
Title or Position	:	VP MANAGED CARE AND REVENUE CYCLE
Name	:	JOSEPH B FISER
Credential	:
Telephone Number	:	910-615-5572

Provider Enumeration Date	:	09/19/2016
Last Update Date	:	12/26/2023

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